tetano
Editor, Senior Moderator
Pathophysiology
. 2021 May 17;28(2):212-223.
doi: 10.3390/pathophysiology28020014.
Critically Ill COVID-19 Patients Exhibit Anti-SARS-CoV-2 Serological Responses
Douglas D Fraser[SUP] 1 2 3 4 [/SUP], Gediminas Cepinskas[SUP] 1 5 [/SUP], Marat Slessarev[SUP] 1 6 [/SUP], Claudio M Martin[SUP] 1 6 [/SUP], Mark Daley[SUP] 1 7 8 [/SUP], Maitray A Patel[SUP] 7 [/SUP], Michael R Miller[SUP] 1 2 [/SUP], Eric K Patterson[SUP] 1 [/SUP], David B O'Gorman[SUP] 1 9 10 [/SUP], Sean E Gill[SUP] 1 4 6 [/SUP], Ian Higgins[SUP] 11 [/SUP], Julius P P John[SUP] 11 [/SUP], Christopher Melo[SUP] 11 [/SUP], Lylia Nini[SUP] 11 [/SUP], Xiaoqin Wang[SUP] 11 [/SUP], Johannes Zeidler[SUP] 11 [/SUP], Jorge A Cruz-Aguado[SUP] 11 [/SUP]
Affiliations
Abstract
Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, is a global health care emergency. Anti-SARS-CoV-2 serological profiling of critically ill COVID-19 patients was performed to determine their humoral response. Blood was collected from critically ill ICU patients, either COVID-19 positive (+) or COVID-19 negative (-), to measure anti-SARS-CoV-2 immunoglobulins: IgM; IgA; IgG; and Total Ig (combined IgM/IgA/IgG). Cohorts were similar, with the exception that COVID-19+ patients had a greater body mass indexes, developed bilateral pneumonias more frequently and suffered increased hypoxia when compared to COVID-19- patients (p < 0.05). The mortality rate for COVID-19+ patients was 50%. COVID-19 status could be determined by anti-SARS-CoV-2 serological responses with excellent classification accuracies on ICU day 1 (89%); ICU day 3 (96%); and ICU days 7 and 10 (100%). The importance of each Ig isotype for determining COVID-19 status on combined ICU days 1 and 3 was: Total Ig, 43%; IgM, 27%; IgA, 24% and IgG, 6%. Peak serological responses for each Ig isotype occurred on different ICU days (IgM day 13 > IgA day 17 > IgG persistently increased), with the Total Ig peaking at approximately ICU day 18. Those COVID-19+ patients who died had earlier or similar peaks in IgA and Total Ig in their ICU stay when compared to patients who survived (p < 0.005). Critically ill COVID-19 patients exhibit anti-SARS-CoV-2 serological responses, including those COVID-19 patients who ultimately died, suggesting that blunted serological responses did not contribute to mortality. Serological profiling of critically ill COVID-19 patients may aid disease surveillance, patient cohorting and help guide antibody therapies such as convalescent plasma.
Keywords: COVID-19; humoral response; immunoglobulins; intensive care unit; outcome; serology.
. 2021 May 17;28(2):212-223.
doi: 10.3390/pathophysiology28020014.
Critically Ill COVID-19 Patients Exhibit Anti-SARS-CoV-2 Serological Responses
Douglas D Fraser[SUP] 1 2 3 4 [/SUP], Gediminas Cepinskas[SUP] 1 5 [/SUP], Marat Slessarev[SUP] 1 6 [/SUP], Claudio M Martin[SUP] 1 6 [/SUP], Mark Daley[SUP] 1 7 8 [/SUP], Maitray A Patel[SUP] 7 [/SUP], Michael R Miller[SUP] 1 2 [/SUP], Eric K Patterson[SUP] 1 [/SUP], David B O'Gorman[SUP] 1 9 10 [/SUP], Sean E Gill[SUP] 1 4 6 [/SUP], Ian Higgins[SUP] 11 [/SUP], Julius P P John[SUP] 11 [/SUP], Christopher Melo[SUP] 11 [/SUP], Lylia Nini[SUP] 11 [/SUP], Xiaoqin Wang[SUP] 11 [/SUP], Johannes Zeidler[SUP] 11 [/SUP], Jorge A Cruz-Aguado[SUP] 11 [/SUP]
Affiliations
- PMID: 35366258
- DOI: 10.3390/pathophysiology28020014
Abstract
Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, is a global health care emergency. Anti-SARS-CoV-2 serological profiling of critically ill COVID-19 patients was performed to determine their humoral response. Blood was collected from critically ill ICU patients, either COVID-19 positive (+) or COVID-19 negative (-), to measure anti-SARS-CoV-2 immunoglobulins: IgM; IgA; IgG; and Total Ig (combined IgM/IgA/IgG). Cohorts were similar, with the exception that COVID-19+ patients had a greater body mass indexes, developed bilateral pneumonias more frequently and suffered increased hypoxia when compared to COVID-19- patients (p < 0.05). The mortality rate for COVID-19+ patients was 50%. COVID-19 status could be determined by anti-SARS-CoV-2 serological responses with excellent classification accuracies on ICU day 1 (89%); ICU day 3 (96%); and ICU days 7 and 10 (100%). The importance of each Ig isotype for determining COVID-19 status on combined ICU days 1 and 3 was: Total Ig, 43%; IgM, 27%; IgA, 24% and IgG, 6%. Peak serological responses for each Ig isotype occurred on different ICU days (IgM day 13 > IgA day 17 > IgG persistently increased), with the Total Ig peaking at approximately ICU day 18. Those COVID-19+ patients who died had earlier or similar peaks in IgA and Total Ig in their ICU stay when compared to patients who survived (p < 0.005). Critically ill COVID-19 patients exhibit anti-SARS-CoV-2 serological responses, including those COVID-19 patients who ultimately died, suggesting that blunted serological responses did not contribute to mortality. Serological profiling of critically ill COVID-19 patients may aid disease surveillance, patient cohorting and help guide antibody therapies such as convalescent plasma.
Keywords: COVID-19; humoral response; immunoglobulins; intensive care unit; outcome; serology.